A Cut off Value for Brain Natriuretic Peptide Indicating Volume Overload in Hemodialysis Patients

Baki, Aber Halim; Mohab, Amr; Reda, Cherry; Morttada, Ayman

doi:10.4172/2472-1220.1000151

Cited by 1 publication

(2 citation statements)

References 16 publications

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“…Using BNP level to assess volume overload is relatively inexpensive; however, due to relatively low specificity, more studies are needed to clarify the effectiveness of BNP level in assessing volume overload in CKD patients [27].…”

Section: Discussionmentioning

confidence: 99%

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Are there any further modalities for prediction of subclinical volume overload in advanced stages of chronic kidney disease?

Baki

Kamel

Mansour

2021

Kidney Res Clin Pract

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Background: Subclinical volume overload in chronic kidney disease (CKD) patient represents a debatable issue. Although many tools were used to detect volume overload in such patients, many non-specific results were due to presence of comorbidities. Bioimpedance spectroscopy is an objective fluid status assessment method, which is shown superior to classical methods in many studies. Combining some of these tools may improve their accuracy and specificity. Inferior vena cava collapsibility index (IVCCI) with brain natriuretic peptide (BNP) can be combined for more specific volume assessment. This study was performed to assess the usage of combined IVCCI and BNP levels in CKD patients to predict subclinical volume overload. Methods: One hundred and ten patients with CKD (stages 4 and 5) not on dialysis and having normal left ventricular systolic function were included in this study. Exclusion criteria were: (1) patients with other causes of raised BNP than volume overload and (2) patients on diuretics. A complete medical history was obtained, and thorough examination and laboratory tests were performed for all included patients. IVCCI and BNP serum levels were evaluated. The patients who exhibited an overhydration (OH)/extracellular water (ECW) ratio of >15% were considered to have volume overload. Results: Twenty-six patients (23.6%) had subclinical hypervolemia as diagnosed by OH/ECW ratio of >15%. IVCCI ≤ 38% had higher diagnostic performance than BNP ≥ 24 pg/mL. Combining both IVCCI ≤ 38% and BNP ≥ 24 pg/mL increased the specificity and positive predictive value for detection of subclinical hypervolemia. Conclusion: Combined elevated BNP level and decreased IVCCI are more precise tools for subclinical volume overload detection in CKD patients.

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Section: Discussionmentioning

confidence: 99%

“…We used the results of Baki et al [27] who demonstrated that the sensitivity and specificity of BNP were 71.0%% and 77.8%, respectively, and the frequency of hypervolemia was 77.5%. We assumed the null hypothesis for sensitivity and specificity as 50.0% each, a power = 0.80 and an α = 0.05.…”

Section: Sample Size Justificationmentioning

confidence: 99%